How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $125.89 | Professional | None | $79.43 | $104.71 | $125.89 |
CareFirst Setting Professional Modifier None Typical Low $81.28 Median $89.13 Typical High $89.13 | Professional | None | $81.28 | $89.13 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $2,691.53 | Facility | None | $489.78 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $107.15 Typical High $186.21 | Professional | None | $72.44 | $107.15 | $186.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $138.04 Median $154.88 Typical High $234.42 | Professional | None | $138.04 | $154.88 | $234.42 |
United Setting Facility Modifier None Typical Low $64.57 Median $144.54 Typical High $616.60 | Facility | None | $64.57 | $144.54 | $616.60 |
United Setting Professional Modifier None Typical Low $69.18 Median $107.15 Typical High $218.78 | Professional | None | $69.18 | $107.15 | $218.78 |
Wellpoint Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $213.80 | Professional | None | $114.82 | $114.82 | $213.80 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $50.12 Typical High $63.10 | Professional | 52 · Reduced service | $39.81 | $50.12 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $19.95 Typical High $25.12 | Professional | 53 · Discontinued | $16.22 | $19.95 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $74.13 Typical High $93.33 | Professional | 54 · Surgery only | $60.26 | $74.13 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $15.14 Typical High $18.62 | Professional | 55 · Aftercare only | $12.02 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.00 Typical High $12.59 | Professional | 56 · Pre-op care only | $7.94 | $10.00 | $12.59 |
Where Maryland sits
The same service costs 3.5 times more in Alaska than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Maryland· 47th of 51
$97.72
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.